News — record audit

More practices today are use electronic dental records. There are certainly pros and cons of doing so, which is beyond the scope of this blog post. What is important is that the software used today allows providers to template their notes, which are often necessarily-detailed. The problem with using templates, especially those with pre-populated answers are whether the answers accurately reflect the patient presentation, diagnostic test results (i.e. x-rays), the dentist’s findings/recommendations, and (ultimately) treatments provided. If yes, great! If no, oh no!

Physician practices and hospitals routinely audit for compliance, risk management, revenue cycle and quality of care issues.  They don’t necessarily like it, but they’ve settled into the routine of doing it to minimize their losses in the ever-increasing fight for dollars between providers and payors. Sadly, few dental practices audit patient records. A lot can be learned from auditing including identification of incomplete or inadequate documentation and/or paperwork, missed billing opportunities, issues that can result in recoupments (even criminal prosecution), and a host of other issues.   A dentist’s work is only as good as his records. It is said...

When a dentist or DSO (or any other healthcare entity) get busted for Fraud, Waste or Abuse (FWA) issues the government may decline criminal prosecution in favor of a civil settlement known as a Corporate Integrity Agreement (CIA). There is much to unpack about CIAs. Here is what I know: Corporate Integrity Agreements have become a favorite tool of the federal government. You can gain valuable insights on how to protect your practice by reading CIAs (and other government enforcement actions). Every CIA includes requirements that the organization incorporate the OIG’s seven core elements (8 if you're a New Yorker)...